Behavioral Health Clinical Coordinator - Telecommute in Colorado or Montana Details

Behavioral Health Clinical Coordinator - Telecommute in Colorado or Montana

UnitedHealth Group - Denver, CO

Employment Type : Full-Time

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

It is expected that each United Healthcare Services employee adhere to UnitedHealth Group (UHG) & Rocky Mountain Health Plans (RMHP) Policies and Procedures, including but not limited to Corporate Mission Statement, Corporate Values & Ethics, and Corporate Code of Conduct.

Under general supervision, assess and triage member needs for behavioral health care. In collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings. Collects and analyzes utilization data. Assists with discharge planning and care coordination. Provides member and provider assistance and consultation with mental health and substance abuse issues and participates in special quality improvement projects.

If you are located within the state of Colorado and Monatna, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

• Provide consultation to providers and/or consumers on a variety of issues including benefit information, safety issues, confirmation of prior authorizations and approvals, procedures for higher levels of care evaluations, and request for an explanation of the level of care, coverage determination, or best practice guidelines
• Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees. The ability to maintain confidentiality is a critical and essential component of this position
• Support outcome focused, evidence-based best practices and guidelines with providers
• Establish and maintain professional working relations with referral sources, community resources, and care providers and be able to identify and communicate network gaps
• Appropriately identify the need for higher level reviews such as staffing, peer review, or MD consultation. Formulate concise case overviews
• Provide management of behavioral health services, including crisis assessment and intervention
• Process pre-authorization and notification of inpatient and other treatment services
• Oversee initial inpatient admission for psychiatric and chemical dependency patients. Provide concurrent review of inpatient and other treatment services
• Conduct patient assessments and determine appropriate levels of care
• Administer benefits, review treatment plans, and coordinate transitions between various areas of care.
• Obtain information from providers on outpatient requests for treatment
• Work with consumers and providers to identify and help fill gaps in care and to help consumers move through the continuum of care as appropriate
• Handle escalated calls and resolve complex issues. Ensure issues or changes are communicated and integrated as appropriate
• Utilize individual thought to organize and validate data and develop reports s (e.g., production reports, utilization reports, compliance reports for internal and external audits, and validation of bed days per thousand)
• Utilize clinical knowledge and critical thinking to apply evidence-based guidelines to clinical scenarios to determine medical appropriateness and appropriate level of care

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• RN or LCSW, LMFT or LPC current and unrestricted clinical license to practice in the State of Colorado
• Minimum 4 years of clinical experience in an appropriate mental health environment or the equivalent
• Demonstrated knowledge of behavioral health service delivery systems emphasizing time-efficient models of intervention
• If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

• Inpatient and dual diagnosis experience with mental health and substance abuse
• Experience working in an environment that required coordinating benefits and utilizing multiple groups and resources for patients
• Experience working with the Medicaid population

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

Colorado Residents Only: The hourly range for Colorado residents is $25.63 to $45.72. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Behavioral Health Clinical Coordinator, RN, LCSW, LMFT, LPC, Telecommute, Telecommuting, Telecommuter, Work From Home, Remote, Denver, Grand Junction, CO, Colorado